Although the movement was active exclusively within Lutheranism, it had a tremendous impact on Protestantism worldwide, particularly in North America and Europe. Pietism originated in modern Germany in the late 17th century with the work of Philipp Spener, a Lutheran theologian whose emphasis on personal transformation through spiritual rebirth and renewal, individual devotion and piety laid the foundations for the movement. Although Spener did not directly advocate the quietistic, legalistic and semi-separatist practices of Pietism, they were more or less involved in the positions he assumed or the practices which he encouraged.

Pietism spread from Germany to Switzerland and the rest of German-speaking Europe, Scandinavia and the Baltics (where it was heavily influential, leaving a permament mark on the region's dominant Lutheranism, with figures like Hans Nielsen Hauge in Norway, Peter Spaak and Carl Olof Rosenius in Sweden, Katarina Asplund in Finland, and Barbara von Krüdener in the Baltics), and the rest of Europe. It was further taken to North America, primarily by German and Scandinavian immigrants. There, it influenced Protestants of other ethnic backgrounds, taking part in the 18th century foundation of Evangelicalism, a vibrant movement within Protestantism that today has some 300 million followers.

The movement reached its zenith in the mid-18th century, and declined through the 19th century, and had almost vanished in America by the end of the 20th century. While declining as an identifiable Lutheran group, some of its theological tenets influenced Protestantism generally, inspiring the Anglican priest John Wesley to begin the Methodist movement and Alexander Mack to begin the Brethren movement among Anabaptists. Though Pietism shares an emphasis on personal behavior with the Puritan movement, and the two are often confused, there are important differences, particularly in the concept of the role of religion in government.

As the forerunners of the Pietists in the strict sense, certain voices had been heard bewailing the shortcomings of the Church and advocating a revival of practical and devout Christianity. Amongst them were the Christian mysticJakob Böhme (Behmen); Johann Arndt, whose work, True Christianity, became widely known and appreciated; Heinrich Müller, who described the font, the pulpit, the confessional and the altar as "the four dumb idols of the Lutheran Church"; the theologian Johann Valentin Andrea, court chaplain of the Landgrave of Hesse; Schuppius, who sought to restore the Bible to its place in the pulpit; and Theophilus Grossgebauer (d. 1661) of Rostock, who from his pulpit and by his writings raised what he called "the alarm cry of a watchman in Sion".

The direct originator of the movement was Philipp Spener. Born at Rappoltsweiler in Alsace, now in France, on 13 January 1635, trained by a devout godmother who used books of devotion like Arndt's True Christianity, Spener was convinced of the necessity of a moral and religious reformation within German Lutheranism. He studied theology at Strasbourg, where the professors at the time (and especially Sebastian Schmidt) were more inclined to "practical" Christianity than to theological disputation. He afterwards spent a year in Geneva, and was powerfully influenced by the strict moral life and rigid ecclesiastical discipline prevalent there, and also by the preaching and the piety of the Waldensian professor Antoine Leger and the converted Jesuit preacher Jean de Labadie.